Zenaida Frias

Cancer of the nasal cavity

The experience with 40 consecutive cases of cancer of the nasal cavity seen over a period of 15 years is presented. Males outnumbered females in a ratio of 5 to 3. Age ranged from 35 to 88 years, and the median age was 67 years. Epidermoid carcinoma accounted for 78% of the cases. Smoking from early age was a noticeable habit among these patients. The median length of smoking history was 51 years. Most lesions were diagnosed in an advanced stage of the disease, 58% of the cases being T3 lesions. Regional lymph nodes metastases were infrequent; only 12% of the patients presented nodes on admission; another 5% developed metastatic nodes during the follow‐up period. An overall 5‐year survival of 56% was obtained. The survival of cases with T1N0 lesions was 91%. Radiation therapy was the treatment of choice employed in 85% of the cases. A 5‐year survival of 50% was obtained in these patients. Irradiation offers an additional means of salvaging recurrences after surgery. The special characteristics of tumors of the nasal cavity merit the evaluation of such lesions separately from tumors of the paranasal sinuses.

Radiotherapy in the treatment of multiple myeloma

Fifty-nine patients with multiple myeloma referred for treatment of painful bony lesions received irradiation to 95 local areas, and 16 of the 59 were irradiated using hemibody techniques. Pain relief was obtained in practically all of the irradiated regions. Most local areas were treated to doses of 3000 cGy in 10 to 15 fractions. Patients with generalized pain due to multiple site involvement were treated with single dose hemibody irradiation, to doses of 600 cGy to the upper hemibody, and of 800 cGy to the lower hemibody. This treatment was well tolerated and side effects minimal. Median survival from diagnosis was 30 months and the survival at 1, 3, and 5 years was 80%, 42%, and 12% respectively. Key articles on radiation therapy of multiple myeloma are reviewed and discussed. Since all patients eventually relapse after chemotherapy, the role of radiotherapy using present techniques should be fully evaluated and considered as an alternative in the primary treatment of multiple myeloma.

The Management of Testicular Seminomas, 1979

The reported results from throughout the world of modern treatment of testicular seminoma are reviewed for the various clinical stages of disease. The three‐year survival rate for 1,346 patients with Stage 1 and 2 disease is 91%. Since the review reveals considerable differences in staging methods, a clinically useful staging system is proposed. Treatment methods are described and discussed. Recommendations are made assuming that patients so treated are clinically evaluated for extent of disease before treatment with currently available techniques, including lymphangiography, CT scanning, perhaps ultrasonography, and serum marker determinations. Although the role of cytoreductive surgery in patients with seminoma, even bulky seminoma, now is limited, occasionally when laparotomy is done, debulking may also be helpful. Effective combination chemotherapy regimens have not been identified. The 28% three‐year survival rate of patients with Stage 3 disease establishes the real need to identify such therapy. Finally, anaplastic seminoma is considered; a recent review by Percarpio indicates that this subtype perhaps is not unlike classical seminoma as far as stage distribution and prognosis is concerned.

Complications after Radiation Therapy for Cervical Carcinoma

A series of 1 139 patients with invasive carcinoma of the cervix uteri who received a complete course of treatment by means of external irradiation followed by intracavitary curietherapy was evaluated in order to assess the results of treatment and, in particular, the radiation complications induced. Complications developed in 145 instances (12.7%). Severe complications occurred in only 3 per cent. Twenty-four cases had more than one complication. Rectosigmoidal injuries accounted for 72 per cent of all complications, and appeared earlier than did bladder complications and within the first two years after treatment. No apparent correlation between age and the occurrence of complications was found. The rate was higher in early stages. The radiation complications did not adversely affect the survival results.

Failures after irradiation in early vocal cord cancer.

Radiation therapy for early laryngeal cancer offers an excellent probability of cure as well as preservation of vocal function. Reported failure rates range from 9 to 21% in patients with T1 lesions, and from 28 to 44% in those with T2 lesions, the majority of whom are subsequently salvaged by surgery.

Red blood cell survival in patients with Hodgkin's disease

Red blood cell (RBC) survival studies were performed in a series of 22 consecutive patients with Hodgkins disease. T 1/2 values ranged from 23 to 45 days, with an average of 32.6 ± 7.1 days. Seventy‐three percent of the patients had values within the normal limits established in the laboratory (36.6 ± 4.3 days). No correlation was found between T 1/2 values and age, sex, or other laboratory findings such as hemoglobin and hematocrit levels, leukocyte, and eosinophil counts. Some degree of association was observed between RBC survival and stage of the disease. Early stages of the disease had normal T 1/2 values, whereas half of the cases in advanced stages of the disease had a decreased RBC survival.

Prognostic Importance of the Intracavitary Radium Arrangement in the Treatment of Carcinoma of the Uterine Cervix

In many patients, it is not feasible to apply a combination of tandem and colpostat in the treatment of carcinoma of the cervix uteri, e.g., in elderly patients or in instances of residual disease in fornices and vaginal walls or shrinkage of the vaginal vault. The authors have employed a long tandem with a protruding source into the upper vagina; the effects of these respective modalities upon prognosis are compared.